Welcome to my blog. HIV prevalence is not a reliable indicator of sexual behavior because the virus is also transmitted through unsafe healthcare, unsafe cosmetic practices and various traditional practices. This is why many HIV interventions, most of which concentrate entirely on sexual behavior, have been so unsuccessful.

Not one single case of sexually transmitted ebola has ever been demonstrated, in nearly 40 years. The presence of the virus in some form in semen has been demonstrated. But the possibility that the virus can be transmitted via that semen has not. And the author is even, to some extent, aware of this.

So why do the media rant on about sexually transmitted ebola? Could it be a continuation of some of the racist views of Africans that date back many decades, perhaps centuries? Several decades (at least) before HIV was identified, it was assumed that prevalence of certain sexually transmitted infections in African countries, such as syphilis and gonnorhea, was a result of 'promiscuity'.

More enlightened researchers published papers, also decades ago, arguing that there was absolutely no evidence that levels of 'promiscuity' were higher in African countries than elsewhere. Some of them also argued that the conditions of health services, along with the living and working conditions to which people in colonial Africa were subjected, were far more significant factors than sexual behavior.

Some of them were reacting to the efforts of the various different eugenics movements to provide 'scientific' evidence for their extraordinary views. However, once HIV was identified and found to be more common in some African countries than anywhere else, the myth of 'African' promiscuity returned. And it remains, explicitly or implicity, in HIV policy, journalism, and in much of the academic writing.

The characterization of African people as promiscuous goes hand in hand with the characterization of African men as sexually incontinent, animalistic, uncaring about those around them, particularly their own family members, and completely unamenable to change.

African women are seen as being entirely incapable of resisting the will of the men around them. They are mere victims, misused and discarded, to be 'rescued' by decent westerners, if they are lucky. They are then subjected to the pity of their rescuers, the journalists who write about them, and others who think this sort of thing 'just shouldn't happen'.

The author claims to have met with members of a women's 'secret society'. We are informed that such societies are "ancient cultural institutions found all over Sierra Leone". We can't gainsay that if we've never been to Sierra Leone, after all, they are secret, although we might ask how secret they are if the author could meet with them.

But, far more important than the claim that ebola is transmitted sexually (and it might be, occasionally), is the tone of the article, about how much women suffer, with the strong implication that this is the fault of Sierra Leonean men. But poverty, bad health, low levels of education, poor living conditions and terrible labor conditions are a fact of life for most people in Sierra Leone, male and female.

Education may be, as the headline says, crucial. But whose education is crucial? Whose knowledge? Whose data? Whose research? This academic seems to have recorded the result of decades of racist informed education, and now presents it to us as the unassailable views of Sierra Leonean women, at least, the ones who belong to these common 'secret' societies.

However, there are promiscuous people everywhere, but most people are not promiscuous. There are violent and abusive people everywhere, and the perpetrators may well be more likely to be male than female. But most people are not violent or abusive. Most men are not. And most women are not mere victims of everything that goes on around them.

This is not to say that there are not huge imbalances and great injustices, with many women suffering, often at the hands of men. But whatever strategy may bring relief to the suffering of women and men, it will not be one based on a puerile and reductive belief in the incredible baseness of African men, coupled with the complete inability of African women to defend themselves in any way.

Ebola, HIV, hepatitis, TB and many other diseases can be transmitted in various ways. One of the modes of transmission for all of them is unsafe healthcare, believe it or not. In the case of HIV, such transmission has been strenuously but entirely unconvincingly denied. Sex is one of several modes of transmission for HIV, but it is unlikely to be a significant mode of transmission of ebola.

But transmission of ebola through unsafe healthcare practices appears to be slipping through the net, as academics indulge in their fantasies about an assumed 'African' sexuality, along with a great love for seeking (female) 'victims' that they can rescue, study, and hopefully write scholarly(ish) papers about. These academics are not just deceiving themselves, they are deceiving those they claim to be concerned about.

Friday, April 24, 2015

One of the big expenses that parents (and orphanages!) face in developing countries like Tanzania is the cost of medicines and treatment. Even healthy children need vaccinations and have lots of other health needs that can only be met using pharmaceutical products. Medical costs run high.

You might think that developing countries would pay less for lifesaving medicines and vaccinations, but you would be wrong. Medical costs are often disproportionately high in poorer countries. Pharmaceutical companies negotiate prices in secret, and countries often have to sign a confidentiality agreement in the process.

There's a vaccine for pneumonia, but it is too expensive for most people in developing countries, and even for NGOs operating in the majority world. Pfizer and GSK, who spend massive amounts on publicity, have failed to negotiate openly and fairly.

This is still a large amount of money and could easily buy the food for ten meals in Tanzania. Conditions such as TB and HIV infect and kill far fewer children acute respiratory infections in this country, yet the medical costs for these are often covered, or partially covered, by international intitives (albeit still at an excessive price).

Top deadly diseases of children and infants

The top killer of children in developing countries is acute respiratory infections. Other big killers are malaria and diarrheal conditions, both of which are preventable. It should be cheap to prevent them, but diarrhea kills another 1.5 million children, globally.

The World Health Organization (WHO) reminds us that "About 44% of deaths in children younger than 5 years in 2012 occurred within 28 days of birth – the neonatal period. The most important cause of death was prematurity, which was responsible for 35% of all deaths during this period."

Many Watoto Kicheko children were born prematurely, and are far more susceptible to pneumonia and other preventable disease as a result. This issue is very close to our hearts.

Pneumonia is a horrible sickness, I have had it myself. But I was lucky to be in the UK, where medical costs and treatment are covered by national insurance. Few people die of pneumonia in the UK, or other wealthy countries.

Watoto Kicheko children face high risk from pneumonia

But it is especially common among children who are weakened by malnutrition, other childhood illnesses, lack of breastfeeding, etc. Therefore, it is something that we at Watoto Kicheko are always watching out for.

Please help raise awareness by supporting the Medicins Sans Frontieres campaign. Doing so will also help the children at Watoto Kicheko, by helping to reduce medical costs.

But one of the Facebook pages may answer some of those questions: in a photograph of about thirty black people, twentynine of whom are male, there is the unmistakable white face of 'Dr', 'Professor' (of epidemiology) Robert C Bailey, of the School of Public Health, University of Illinois at Chicago.Aggressively pushing mass male circumcision as an antidote to HIV and a host of other possible ailments for more than twenty years, Bailey's name has appeared on many of the published papers promoting the operation, with even the wildest of claims remaining unchallenged by most other academics.His 'NGOs' may have undergone several name changes for good reason. He is one of the biggest recipients in Kenya (where about 85% of men are already circumcised) of the hundreds of millions of dollars said to be available for mass male circumcision programs. But the fate of some of those millions of public dollars is not always transparent.Another of his 'NGOs' is called the Nyanza Reproductive Health Society (NHRS). The NHRS is similarly secretive and merely recycles the same sort of publicity blurb as IRDO. Kenya's Standard newspaper covered the allegations of misuse of funds by NHRS a few years ago.The Nation author seems impressed with the fact that the children were said to have been 'lured with sweets', which is probably the mass male circumcision campaigners' pediatric version of luring people with bullshit about how circumcision, not only 'protects' you from HIV and other STIs, but also ensures greater attractiveness to women, better orgasms and 'hygiene' (as if intact men are unable to clean their penises and circumcised men don't need to!).Although circumcision is contrary to the cultural practices of the communities that the victims come from, incidents like this don't appear to have resulted in any greater recognition of how serious a crime this is. In contrast, there is a lot of international money and attention for preventing female genital mutilation, especially where this is in keeping with the cultural practices of the communities where it is practiced.Is it because those involved are male that this is not really seen as mutilation? It is clearly a denial of the right to bodily integrity. Carrying out an operation that involves removal of healthy flesh without consent is always wrong; it is always mutilation, regardless of the gender of the victim.Perhaps because the money comes from the US, where male circumcision is very common, it is felt that Kenyan people should just put up and shut up (as they seem to have done so far). This is an issue for Kenyan people of all ethnicities to address themselves, whether they practice circumcision or not.Kenyan children have a right to be protected from such abuses, as do Kenyan adults, male and female. It's time to question large amounts of money being made available to carry out dubious 'research' projects, with Kenyans being used as cheap research fodder.

Tuesday, April 14, 2015

One of the most effective ways of keeping newborns, infants and under fives alive is by making sure that their mother does not die. That means supporting women who are planning to have children, who are pregnant, or who already have young children.

I would suggest that one of the best potential sources of support for mothers-to-be and mothers, is fathers. A lot of NGOs make a big deal of working exclusively with children, infants or mothers. But ignoring fathers, or even worse, branding them as in some way wayward, is not helpful.

Including fathers more in pregnancy and birth has not yet developed very much here in Tanzania. Some women will tell you they don't want their husband there, and some men will tell you that they don't want to be there, during the delivery.

But one of the biggest sources of opposition to fathers being present when their wives are giving birth in Tanzania, and even when they go for antenatal care, may be health facilities themselves. Health personnel in East Africa currently have a disproportionate influence on the treatment patients receive, with the wishes of the patients often being sidelined.

I have been present for the birth of my two sons here in Tanzania, the first time in Dar es Salaam and the second in Moshi. I have yet to meet a nurse who thinks it is a good idea for fathers to be present when their wife is giving birth. It is possible to persuade doctors, but many people can't afford a consultation with a doctor, and rely on the professionalism of nurses and other staff.

Perhaps Tanzanian fathers don't realize that their mere presence could strongly influence the sort of treatment their wife receives? Nurses would feel under more pressure to treat pregnant women with respect, which they do not always do when there is no one to stand up for them. Or fathers could be there just to ensure that their wives get the minimum level of attention they need, when they need it.

Tanzanians are well aware that health facilities are in bad condition, and that will not change in a hurry. They are also aware that health personnel are often far too stretched to prioritize simple courtesy. Indeed, many patients and those accompanying patients will admit that they fear being shouted at by nurses and health personnel in front of other patients, and are often too intimidated to say anything at all.

If fathers attend at least one antenatal care visit and express their wish to be present when their wife is giving birth, they can start to exert a lot more influence over the care their wives receive. Better care is safer care, and safety is paramount; safety is one of the main reasons for giving birth in a health facility, with a health professional present, it is one of the main reasons why maternal, newborn, infant and under five deaths have declined in the past few decades.

But they haven't declined nearly enough yet. Recent figures show that 26 newborns die out of every 1000 live births; 51 infants die out of every 1000 live births; and 81 under fives die out of every 1000 live births. Infants and under fives, who should be facing fewer serious health risks as they get older, are more likely to die, as if they cease to matter so much once they are no longer newborns.

Maternal mortality stands at 454/100,000 live births, and that rises to much higher levels in certain hospitals. This includes the Muhimbili Maternity Hospital, the biggest and most prominent in the country, where mortality is about three times higher than average.

It's hardly surprising that only about half of all births in Tanzania take place in health facilities!

Just being with your wife when she is giving birth can improve the care she receives. Just being in the delivery room with her can remind those attending to her that there is a reason for the father to be there; he is concerned about his wife's safety as she gives birth.

If women survive birth and leave the hospital as healthy as they were when they arrived, they will be able to give their newborn and their other children the attention they need. Newborns, infants and under fives will be healthier, and more likely to survive, go to school, grow up and have healthy children themselves.

Antagonistic attitudes towards men are detrimental to the lives of all those we profess to care about. The attitudes of NGOs and of health professionals, as well as the attitudes of men and women, need to change.

So the victims have now launched a lawsuit against the Johns Hopkins University over its involvement, something the university has 'vigorously denied'. The university has expressed 'profound sympathy', which I'm sure the victims and their families will appreciate.

These vigorous denials were echoed by the Rockefeller Foundation, who also claim to have had nothing to do with the experiments. Big Pharma giant Bristol-Myers Squibb declined to comment.

This infamous episode in the history of American public health experimentation overlapped with the much longer and more extensive Tuskegee Syphilis Experiment (1932-1972). Although this occurred within the US, the victims were African-Americans, so the vigorous denials and profound sympathies were not deemed necessary until some time after the experiments had been halted.

Carrying out questionable public health programs in non-US countries by US institutions is a lot more common now. Injectible Depo Provera hormonal contraceptive (DMPA) is rarely used among non-white or wealthy populations, inside or outside the US. This is despite the fact that the drug has been shown to double the rate of transmission of HIV from HIV positive men to HIV negative women, and from HIV positive women to HIV negative men.

The vigorous denials continue: just search for #DMPA on Twitter and the same faces come up over and over. The tweeters often attack anyone questioning the use of DMPA, especially among poorer non-white women in the US and among people in African and Asian countries, where it is often the most common form of birth control used.

Those defending DMPA don't generally deny that it doubles HIV risk, as they are often among the research teams who estimated this risk in the first place. They tend to argue that a doubling of risk is not high enough to warrant issuing proper warnings, and that the risk of being infected with HIV is not as serious as the risk that those using DMPA may have an unplanned pregnancy, as if there are no other contraceptives available!

Spite towards Africans expressed through dangerous 'public health' programs was entirely normalized once it was decided, for purely political reasons, that HIV should be marketed as a sexually transmitted infection that heterosexuals were very likely to contract and transmit.

Although the virus mainly infects men who have sex with men (MSM) and intravenous drug users (IDU) in wealthy and middle income countries, it mainly infects people who are neither MSM nor IDUs in Africa. In fact, the largest demographic infected in most African countries is women from their mid teens up to their late forties.

How could this be so?

Well, if you've ever had the misfortune of being treated in an African hospital, given birth there, or even just visited someone you know, you will find it very easy to believe that unsafe healthcare constitutes a huge, but under-researched risk. Less of a risk, but also under-researched, are unsafe cosmetic and traditional practices.

Consider this when reading about some of the experiments carried out in Guatemala: "Prostitutes were infected with venereal disease and then provided for sex to subjects for intentional transmission of the disease", syphilis was injected into the spinal fluid of some victims.

Children were also subjected to these 'experiments', as were orphans, prisoners and mental health patients. Some of those involved were worried about what people not involved might think if they found out, but they don't seem to have worried about their victims; one woman is reported to have had gonnorheal pus from a male subject injected into both her eyes.

But it's not only African (or African American) women that are so maligned by wealthy western institutions that massive 'public health' experiments can be carried out using public money, often resulting in private gain, with total impunity. The English Guardian article notes two 'experiments' carried out on men, aiming to infect them with sexually transmitted infections and then watching the effect this had on them, their families and others around them.

For example, "An emulsion containing syphilis or gonorrhoea was spread under the foreskin of the penis in male subjects" and "The penis of male subjects was scraped and scarified and then coated with the emulsion containing syphilis or gonorrhea".

This obsession with sex, sexuality and sexual organs continues to occupy publicly (and privately) funded western HIV scientists in African countries. Research into non-sexual transmission of HIV is almost unheard of, except in the form of 'vigorous denial' that it ever occurs.

These circumcision programs are targeted, like Tuskegee, Guatemala and the use of Depo Provera, at non-white, poorer people, often African and female (while the MMC programs must target men, the operation has been shown to double transmission from males to females).

Data collected is often published selectively, to promote funded interests, and anything that suggests the programs are harmful is either uncollected, ignored or remains unpublished. Those criticizing such practices are attacked, branded, ridiculed and persecuted by professional (and often very well qualified) trolls.

In years to come, articles in the English Guardian may describe these appalling practices, that occurred in the past, as if they could never happen in the present. But similar phenomena continue to occur, with funding from western governments, 'philanthropists', academic institutions and others, while the public (and the media) look the other way.

The true injustice is that many women in African countries are infected with HIV through non-sexual routes, probably through unsafe healthcare, but also possibly through unsafe cosmetic and traditional practices that involve skin piercing. These infections are avoidable: women need to be told that they face such risks, that HIV is not just a sexually transmitted virus, that it is not even predominantly sexually transmitted.

As long as the media continues to spew out the misogynistic rubbish they receive from UNAIDS and the HIV industry's PR machinery about HIV almost always being transmitted through unsafe heterosexual sex in African countries (but not elsewhere), countries like Kenya will pass unjust laws like this one.

The media also loves rubbish about 'deliberate' transmission of HIV, 'revenge' transmission, anything extreme, which they depict as normal for Africa. The level of anti-African bigotry to be found in the media is on a par with the kinds of antisemitism that was commonplace in many countries before the second world war.

Prevention of mother to child transmission of HIV (PMTCT) is a wonderful technology, and has probably saved many lives and averted numerous infections. But what about averting infections in the women first? This would be the best strategy for averting infections in infants.

It is of vital importance for women to know what HIV risks they face, so that they can take measures to protect themselves. The Guardian's humbug conclusion that "The law also puts women at risk of violence or rejection by their husbands because it allows doctors to disclose the status of patients to their next of kin" needs to be rewritten.

It is the HIV industry and institutions like UNAIDS that insist that women's biggest risk for infection with the virus, even their only risk, is unsafe sex. Many African women have just one sexual partner, and that person is HIV negative. Many HIV positive women were infected late in their pregnancy, even just after giving birth.

It is unpardonable to insist that all HIV positive mothers must have had sexual intercourse with someone other than their partner. This is what puts the women at risk of stigmatization, violence and rejection, as well as at risk of being infected with HIV, and infecting their fetus or infant.

This kind of victim blaming is a clear instance of violence against women, yet it is promulgated by the very parties who claim to be protecting the rights of women: UNAIDS, WHO, various academic instutions and the enormous, top-heavy HIV industry that they and others constitute. And the media tag along, like poodles doing tricks for the odd pat on the head.